系统性炎症反应指数对蜂蛰伤患者发生多脏器功能障碍综合征的预测价值

The predictive value of the Systemic Inflammatory Response Index for the occurrence of Multiple Organ Dysfunction Syndrome in patients with wasp sting injury? Zhang Yu-pei,Wu-Wen,Zhang Chao-hui.The First College of Clinical Medical Science, China Three Gorges University, Yichang443000, China.

关键词: 蜂蜇伤  系统性炎症反应指数  多器官功能障碍综合征

Keywords: Wasp sting  systemic inflammatory response index  multiple organ dysfunction syndrome

摘 要: ［］ 目的 本研究旨在分析蜂蛰伤患者发生多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的危险因素。方法 采用回顾性研究方法,收集了三峡大学第一临床医学院从2013年7月至2023年4月收治的226例胡蜂蜇伤住院患者的临床资料。将患者分为MODS组和非MODS(Non-multiple organdys function syndrome,NMODS)组,并比较两组患者的一般资料、临床症状、实验室指标及预后情况等。单因素分析两组间有差异指标,将差异指标纳入多因素Logistic回归分析中,以发生MODS为因变量,分析其独立危险因素。采用受试者工作特征性曲线(receiver operating characteristic curve,ROC曲线)分析SIRI预测胡蜂蛰伤发生MODS的价值。结果 共有214例胡蜂蛰伤患者,其中非MODS组109例,MODS组105例。两组患者的系统性炎症反应指数(systemic inflammatory response index,SIRI)分别为1.6(0.7,3.6)和12.2(5.2,23.3),两组间存在显著差异(P ＜0.001)。SIRI是胡蜂蛰伤患者发生MODS的独立危险因素；SIRI预测胡蜂蛰伤发生MODS的AUC为0.886(P ＜0.001),最佳截断值为6.3917时敏感度为71.43％,特异度为94.5％,具有预测价值。SIRI定义为外周血中性粒细胞×单核细胞/淋巴细胞的比值。结论 SIRI可以有效预测蜂蛰伤患者的病情严重程度,并且能够及早识别,帮助医生及时进行临床干预和治疗。

Abstract: Corresponding author: Zhang Chao-hui,E-mail: [e-mail]
? :Obiective This study aimed to analyze the risk factors for the occurrence of multiple organ dysfunction syndrome (MODS) in patients with wasp sting.? Methods A retrospective study was conducted, and clinical data of 226 hospitalized patients with wasp sting from July 2013 to April 2023 in the the first college of clinical medical science of China three gorges university were collected. The patients were divided into MODS group and non-MODS (NMODS) group, and the general data, clinical symptoms, laboratory indexes, and prognosis were compared between the two groups. The indicators with significant differences in univariate analysis were included in the multivariate Logistic regression analysis to analyze the independent risk factors for MODS. The value of SIRI in predicting the occurrence of MODS in wasp sting was analyzed by using the receiver operating characteristic curve (ROC curve).? Results? Of the 214 patients with wasp sting, 109 cases were in the NMODS group, and 105 cases were in the MODS group. The systemic inflammatory response index (SIRI) was 1.6 (0.7, 3.6) and 12.2 (5.2, 23.3) in the NMODS group and MODS group, respectively, with a significant difference between the two groups (P＜0.001). SIRI was an independent risk factor for MODS in patients with wasp sting; the AUC of SIRI in predicting MODS in wasp sting was 0.886 (P＜0.001), and the optimal cutoff value was 6.3917, with a sensitivity of 71.43% and a specificity of 94.5%, which had prediction value. SIRI was defined as the ratio of neutrophils × monocytes to lymphocytes in peripheral blood.? Conclusion SIRI can effectively predict the severity of the disease in patients with wasp sting and can identify it early to help doctors carry out clinical intervention and treatment in a timely manner.